PGY1 Pharmacy – Ambulatory Care Track
The PGY1 Pharmacy Residency programs at University of North Carolina Medical Center will build on the Pharm.D. Education to contribute to the development of competent and confident clinical pharmacists responsible for medication-related care of patients with a wide range of conditions, eligible for board certification, and postgraduate year two (PGY2) pharmacy residency training.
The PGY1 Pharmacy Residency, Ambulatory Care Track, is a 12-month program designed to develop residents into strong and capable pharmacy practitioners with additional experience in the ambulatory care setting. Through exposure to general and specialty ambulatory care experiences, as well as experiences in acute care medicine and administration, the resident will gain broad exposure to areas of patient care and pharmacy which have impacts on practice in the ambulatory care setting. The program is designed based on the belief that the best ambulatory care providers are those who clearly understand what patients experience throughout the continuum of care, through clinic, acute care, and transitional care environments.
Residents will receive training and orientation to the department's services for about 6 weeks during the months of June and July. Over the course of the residency year, residents must complete an average of 400 hours of staffing. Pharmacy practice responsibilities include staffing in decentralized or central pharmacist positions. Activities include, but are not limited to, verifying patient-specific orders and medications, providing pharmacokinetic consults when requested, answering in-depth drug information questions, attending all adult codes as the pharmacy member of the code team, providing patient education and solving pharmacotherapy situations as they may arise.
For PGY1 residents, this commitment is fulfilled by staffing every third weekend and for three concentrated week-long blocks distributed over the course of the year. Additionally, residents are also responsible for staffing during one of three major holiday blocks (Thanksgiving, Christmas, or New Year’s) and one of three minor holidays (Labor Day, Martin Luther King, Jr Day or Memorial Day). These requirements may be changed annually based on the needs of the department.
Clinical On-Call Program
The department of pharmacy provides an on-call pager service to our physicians, nurses, and other clinical staff. While this service does not have an in house on-call component, the residents do participate in answering on-call drug-information requests or following-up on results from patient-specific protocols 24-hours a day. Residents are the primary point of contact for the gram-positive bacteremia rapid diagnostic testing and heparin-induced thrombocytopenia protocols which require a rapid response. The resident will also field time-sensitive questions from medicine, surgery, or oncology service lines overnight. For these questions, can require significant time to research, or a specialized knowledge base; there are PGY2 residents and clinical pharmacists from specific service lines available as back-up at all times. Each PGY1 resident will rotate through primary on-call responsibilities throughout the year.
UNC PGY1 residents are incorporated into a layered learning model with students (PY2, PY3, or PY4) on rotation at UNC Hospitals, co-residents, including PGY2s, and clinical specialists. Our layered learning model has been piloted on several rotations in which learners of various levels participated on the same team. This model will continue to be offered on many of our rotations. Other educational opportunities include POD discussions, case conferences and continuing education series.
POD discussions are topic discussions determined by preceptors ahead of time which can be led either by PGY2s on rotation or a preceptor specializing in that topic.
Case conferences are interactive, didactic and case-based weekly opportunities headed by PGY1 residents. The residents work with clinical experts in the topic area to develop the 1 hour long session that will give residents exposure to core concepts that all PGY1s should be exposed to during the year.
Residents also develop and present a 1-hr ACPE accredited presentation that is available for all UNC Health pharmacists in the system. There are over 40 live sessions presented by UNC residents throughout the year that are available as a webinar based platform and can be viewed by any pharmacist in the country.
These are all weekly opportunities for the resident to develop a more complete pharmacotherapy foundation.
Each resident is expected to participate in multiple projects throughout the year. During the Drug Information, Policy, and Medication Safety rotation each resident will complete a medication-use evaluation. The MUE is a performance improvement tool that can be used to benefit the UNC Health group across the state of North Carolina.
Each PGY1 is also responsible to complete a research project that enhances learning objectives and this is done a 2-step flipped model. During the summer, each resident is assigned to an IRB approved research project and focus on collecting and summarizing data, analyzing results, and presenting findings at a regional or national meeting. During the second half of the residency year, the flipped model residents prepare results of their project for publication while also developing a research question and criteria that is proposed to the Research Committee. Approved projects for the next PGY1 class will go through the IRB process. Feedback from the Research Committee is provided at each stage of the year. Parts of these research projects will be presented at the Vizient Annual Meeting, the Research in Education and Practice Symposium (REPS) or at specified sub-specialty meetings as determined by the residency program director. In addition to conducting and presenting research, residents are required to submit a manuscript for publication over the course of the year.
Our primary teaching experience is provided through the University of North Carolina Eshelman School of Pharmacy. Each PGY1 resident will serve as a teaching assistant for the Patient Care Lab and Foundations of Patient Care courses, in which residents work with first and second year pharmacy students. The residents will help facilitate lessons in therapeutic case discussions and to instruct in the basics of physical assessment, patient counseling and written and verbal communications. An average of five hours per week is committed to this experience, including teaching, preparation, and grading of assignments.
Residents are offered the option to pursue completion of the Teaching and Learning Certificate Program at the UNC Eshelman School of Pharmacy. A significant number of activities in the TAing experience and other longitudinal requirements over the course of the year, apply towards the requirements of the program. An application process is necessary to join the teaching and learning certificate program, and if accepted, residents will be provided guidance on lectures, portfolio development and PCL participation to receive their certificate.
Residents may be given the opportunity to present academic lectures within the School of Pharmacy or other healthcare professional schools throughout the year. These opportunities will be discussed with residency leadership to ensure a successful experience.
UNC residents are offered the option to pursue completion of a leadership certificate through participation in the UNCH Pharmacy Residency Leadership Certificate Program. An application process is necessary to join the leadership certificate program, and if accepted, residents will be provided guidance on leading topic discussions, leadership in motion projects, mentorship, and other activities to receive their certificate. The certificate program’s vision is to develop leaders in pharmacy who will serve others, improve their communities, and advance the profession.
Each resident will be also given the opportunity to participate in longitudinal leadership responsibilities throughout the year that can involve but not limited to recruitment, webpage update, orientation planning, and many more. Residents will have the opportunity to apply for a chief resident position that has a term of 6 months. This gives 2 PGY2s and 2 PGY1s the opportunity to serve in this position.
PGY1 residents are required to attend the annual NCAP Residency Convention in July and the Research in Education and Practice Symposium (REPS) in May. Residents are provided professional days to attend up to 2 professional meetings during the year, such as but not limited to ASHP Midyear Clinical Meeting.
Residents are at the core of being involved in a majority of initiatives for residents and members of the department of pharmacy, school of pharmacy, and the community.
The pharmacy residents are involved in the nation’s oldest interprofessional student-run free healthcare organization called SHAC. SHAC stands for Student Health Action Coalition that focuses on providing care to community members in need and educate student healthcare professionals.
Residents at UNC Medical Center are also involved in beginning initiatives, such as the ReCHARGE Committee. ReCHARGE stands for REsidents Creating Healthy and Resilient Group Environments and the mission is to create a sustainable environment that fosters resiliency and well-being, driven by and designed for pharmacy residents. This group focuses on advocacy and engagement around resident well-being and providing resources for our residents during the residency year.
The residency program at UNC has a strong history of mentorship and this ideal is built into nearly all aspects of residency training. Each resident will have multiple mentors for multiple purposes throughout the year. Mentors are assigned or chosen by the residents for research projects, presentation development, and personal mentorship. The personal mentor exists to guide the resident through the academic year. The mentor is an individual who can answer questions, provide feedback, and counsel residents on how to approach the many challenging parts of the residency year. Mentors of PGY1 residents participate in all quarterly evaluations and monitors the growth and development of residents over the course of the year with residency leadership.
Evaluations are a large part of the residency process. At UNC, we utilize the ASHP-endorsed online evaluation system, PharmAcademic. Evaluations are built for each individual rotation, as well as for presentations, research, and staffing components of the program. Additionally, quarterly global evaluations are held with the program director, coordinator and/or mentor to ensure progress on long term goals.
During the year, residents are given the opportunity to spend time together as an entire class. During orientation, residents participate in a bonding weekend in the local area to get to know one another and the area that residents will be spending during the year. As the year wraps up, the department coordinates the schedule to allow all residents to be off on the same weekend and plan a Spring Trip to give the residents a break and celebrate the successes of the year before graduation.
While the focus of our program is the provision of patient care, our residents leave our programs and pursue a variety of different positions, including further PGY2 training, fellowship training, or clinical employment. A majority of PGY1 residents complete PGY2 residencies in specialty fields. From there, many have taken on roles as clinical pharmacists nationwide and even worldwide.
In these roles, a majority of our graduates are now involved in residency training at their own institutions. Others have pursued successful academic careers at schools of pharmacy nationwide, or further specialty training in either fellowships or graduate studies. Opportunities for residents upon completion of the UNC Training Program are abundant and represent a wide scope of practice styles and settings.
All residents are required to have a North Carolina license by July or reciprocity by September of their residency year. Please contact Moo Sultan for more information.